Autor(es)Simon Fabrice, Parola Philippe, Grandadam Marc, Fourcade Sabrina, Oliver Manuela, Brouqui Philippe, Hance Pierre, Kraemer Philippe, Ali Mohamed Anzime, de Lamballerie Xavier, Charrel Rémi, Tolou Hugues

ResumoA large chikungunya virus (CHIKV) outbreak emerged in 2005-2006 in the Indian Ocean isl-s, including Comoros, Mayotte, Mauritius, the Seychelles, - particularly in Reunion Isl- where 35% of 770,000 inhabitants were infected in 6 months. More recently, circulation of the virus has been documented in Madagascar - in India where CHIKV is spreading rapidly. CHIKV-infected visitors have returned home to nonendemic regions from these isl-s. We conducted a 14-month prospective observational study on the clinical aspects of CHIKV infection imported to Marseilles, France, in travelers returning from the Indian Ocean isl-s. A total of 47 patients have been diagnosed with imported CHIKV infection confirmed by serology, reverse transcription-polymerase chain reaction, -/or viral culture. At the early stage of the disease (within 10 days of the disease onset), fever was present in 45 of 47 patients. A rash was present in the first week in 25 cases. All patients suffered with arthritis. The most frequently affected joints were fingers, wrists, toes, - ankles. Eight patients were hospitalized during the acute stage, including 2 severe life-threatening cases. A total of 38 patients remained symptomatic after the tenth day with chronic peripheral rheumatism, characterized by severe joint pain - multiple tenosynovitis, with a dramatically limited ability to ambulate - carry out activities in daily life. Three patients were hospitalized at this stage for severe persistent h-icap. Follow-up demonstrated slow improvement in joint pain - stiffness despite symptomatic treatment, mainly antiinflammatory - analgesic drugs. In the current series we describe 2 stages of the disease, an initial severe febrile - eruptive polyarthritis, followed by disabling peripheral rheumatism that can persist for months. We point out the possibility of transitory peripheral vascular disorders during the second stage - the occasional benefit of short-term corticosteroids. As CHIKV could spread throughout the world, all physicians should be prepared to encounter this arboviral infection.

ImprentaMedicine, v. 86, n. 3, p. 123-137, 2007

DescritoresChikungunya virus - DNA ; Chikungunya virus - Pathogenesis ; Chikungunya virus - Infectious diseases ; Chikungunya virus - Serology ; Chikungunya virus - Viral infections ; Chikungunya virus - RT-PCR ; Chikungunya virus - Serology ; Chikungunya Virus - Virus ; Chikungunya virus - Chikungunya fever ; Chikungunya virus - Epidemiology ; Chikungunya virus - Public health

Data de Publicação:2007